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    <title>社会保险经办业务证明事项告知承诺制</title>
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<body>
    <div id="outBox">
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            <div  class="frmBox">
                <form id="submitForm" class="submitForm">
                    <table  class=" table-hover">
                        <thead>
                            <caption style=" caption-side: top;">
                                <h2 class="tit">社会保险经办业务证明事项告知承诺制</h2>
                                <h2 class="tit2">承 诺 书</h2>
    
                            </caption>
                        </thead>
    
                        <tbody>
                            <tr>
                                <td valign="center" rowspan="1" colspan="1" class="td1"
                                    style=" width:40px; height: 20px; border-width: 1px; border-style: solid;">
                                    <p class="p3">申请人:_________
                                    </p>
    
                                </td>
                                <td valign="center" rowspan="1" colspan="1"
                                    style=" width:40px;height: 20px; border-width: 1px; border-style: solid;">
                                    <p class="p3">身份证件号：_______________</p>
    
                                </td>
                            </tr>
    
                            <tr>
                                <td valign="center" rowspan="1" colspan="2"
                                    style=" width:40px; height:40px; border-width: 1px; border-style: solid;">
                                    <div class="textBox">
                                        <p>办理业务及证明材料</p>
                                        <p class="p1">企业离退休人员供养直系亲属生活困难补助核定支付</p>
                                        <div class="row">
                                            <div class="input-box">
                                                <p class="p1 name">姓名：<span>______</span> </p>
                                               
                                            </div>
                                            <div class="input-box">
                                                <p class="p1">性别：<span>______</span></p>
                                            </div>
                                            <div class="input-box">
                                                <p class="p1">年龄：<span>______</span></p>
                                            </div>
                                            <div class="input-box">
                                                <p class="p1">周岁（身份证号：<span>________________________</span></p>
                                            </div>)
                                        </div>
    
                                        <div class="row">
                                            <div class="input-box">
                                                <p class="">现居住于<span>__________________________________________</span></p>
                                                <aside class="">,系_____________________________</aside>
                                            </div>
                                        </div>
    
    
                                        <div class="row">
                                            <div class="input-box">
                                                <input type="text" autocomplete="off" class="layui-input inputbox2 place"
                                                    name="" id="address" />
                                                <p class="">（单位名称）退（离）休死亡人员</p><br>
                                            </div>
                                        </div>
    
                                        <div class="row">
                                            <div class="input-box">
                                                <p class="">（姓名）</p> <input type="text" autocomplete="off"
                                                    class="layui-input inputbox2 username" name="" id="recordname" />
                                            </div>
                                            <div class="input-box">
                                                <p class="p1">性别：</p><input type="text" autocomplete="off"
                                                    class="layui-input inputbox2" name="" id="sex" />
                                            </div>
                                            <div class="input-box">
                                                <p class="p1">身份证号：</p><input type="text" autocomplete="off"
                                                    class="layui-input inputbox2 idcard" name="" id="idNumber" />
                                            </div>
                                            <div class="input-box">
                                                <p class="p1">，之 <span>_______</span></p>
                                              
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="input-box">
                                             
                                                <p class="">（关系）。退（离）休人员</p> <input type="text" autocomplete="off"
                                                    class="layui-input inputbox2  " name="" id="recordname2" />
                                            </div>
                                            <div class="input-box">
                                                <p class="p1">于</p>
                                            </div>
                                            <div class="input-box">
                                                <p class="p1"><span>______</span>年</p>
                                            </div>
                                            <div class="input-box">
                                                <p class="p1"><span>______</span>月</p>
                                            </div>
                                            <div class="input-box">
                                                <p class="p1"><span>______</span>日死亡。 </p>
                                            </div>
                                            <div class="input-box">
                                             
                                                <p class="p1"><span>___</span>（遗属本 </p>
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="input-box lastIn">
                                                <p class="">人）无工作，主要生活来源系依靠</p> <input type="text" autocomplete="off"
                                                    style="width: 13% !important;" class="layui-input inputbox2  " name="" 
                                                    id="recordname3" />
                                                <p>（死亡人员）生前供给，生活困难，符</p>
                                            </div>
                                        </div>
                                        <p class="lastIn2">合《中华人民共和国劳动保险条例实施细则修正草案》规定的供养直系亲属条件，现申</p>
                                        <p class="lastIn2">请享受供养直系亲属生活困难补助。</p>
                                    </div>
    
                                </td>
                            </tr>
    
                            <tr>
                                <td valign="center" rowspan="1" colspan="2"
                                    style=" width:40px; height:40px; border-width: 1px; border-style: solid;">
                                    <div class="contentBox">
                                        <p class="p2">承诺内容：</p>
                                        <p class="p4">本人已认真阅读《社会保险经办业务证明事项告知承诺制告知书》及相</p>
                                        <p class="p5">关规定，对社会保险公共服务事项证明义务和办理条件已充分知晓。在此本</p>
                                        <p class="p5">人郑重承诺，已经符合本业务办理条件，填报和提交的所有信息均真实、准</p>
                                        <p class="p5">确、完整、有效，并授权同意经办机构通过其他部门、机构、企业查询与承</p>
                                        <p class="p5">诺相关的个人信息，用于核实承诺内容的真实性。同时，知悉本人如作出不</p>
                                        <p class="p5">实承诺，将被列入社会保险领域严重失信人名单，相关失信信息将在“信用</p>
                                        <p class="p5">中国”、人社门户网站等媒介公示，并接受由相关部门实施包括限制乘坐飞</p>
                                        <p class="p5">机、乘坐高等级列车和席次、获得贷款授信，通报批评，公开谴责等在内的</p>
                                        <p class="p5">跨部门联合惩戒，涉及犯罪的移交司法机关处理。</p>
    
    
                                    </div>
    
                                </td>
                            </tr>
                            <tr>
                                <td valign="center" rowspan="1" colspan="1"
                                    style=" width:40px;  border-width: 1px; border-style: solid;">
                                    <p class="p3">承诺人：_________</p>
    
                                </td>
                                <td valign="center" rowspan="1" colspan="1"
                                    style=" width:40px;  border-width: 1px; border-style: solid;">
                                    <p class="p3">身份证件号：_________</p>
    
                                </td>
                            </tr>
    
                            <tr>
                                <td valign="center" rowspan="1" colspan="2"
                                    style=" width:40px; height:40px; border-width: 1px; border-style: solid;">
                                    <p class="p6">与申请人关系：本人/法定监护人（勾选）</p>
                                </td>
                            </tr>
                            <tr>
                                <td valign="center" rowspan="1" colspan="2"
                                    style=" width:40px; height:40px; border-width: 1px; border-style: solid;">
                                    <div class="row">
                                        <div class="input-box">
                                            <p>承诺日期：</p> 
                                            <p class="p1">____年</p>
                                        </div>
                                        <div class="input-box">
                                            <p class="p1">____月 </p>
                                        </div>
                                        <div class="input-box">
                                            <p class="p1">____日 </p>
                                        </div>
                                    </div>
                                </td>
                            </tr>
                        
    
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